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Form 668 (Y)(c) Department of the Treasury - Internal Revenue Service
(Rev. February 2004) Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 110459514
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien in favor of the United States on all property and rights to
property belonging to this taxpayer for the amount of these taxes, and �3 �-
M C0 L -'r ;
additional penalties, interest, and costs that may accrue. z m c M--
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Name of Taxpayer DANIEL J GALLO t�fsr" ;
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Residence
1712 LETCHWORTH RD cam _-=
CAMP HILL,. PA 17011-7528
-C .063. a
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shall,
on the day following such date, operate as a certificate of release as defined ;21--50
in IRC 6325(a). ./f 3D90//.-
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2013 XXX-XX-9494 06/02/2014 07/02/2024 32311 . 96
Place of Filing
Prothonotary
Cumberland County Total $ 32311 . 96
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 18th day of July 2014
Signature � REVENUE OFFICER 22-06-2624
for JAKOB A PEDERSEN (717) 777-9621
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466, 1971- 2 C.B. 409)
Part 1 - Kept By Recording Office Form 668( CAT (Rev. 2-2004)
CAT. NO 60025X